HomeMy WebLinkAboutStreet Cut Permits 381 Governors highway (2) 1800013 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 02/28/2018
GIS ID: 36900381 FEE: 50.00
MUNIS APPLICATION# 201800245 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 381 GOVERNORS HIGHWAY
ADDRESS: 112 PROSPECT HILL ROAD OWNER: J R SILVESTER SPACE SERVICES LLC
EAST WINDSOR,CT 06088 105A FILLEY ST-REAR
BLOOMFIELD, CT 06002
PHONE
WORK DESCRIPTION: REPAIR GAS SERVICE '
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND THE APPLICANT IS FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
2/28/2018 11:52 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 19 00013 CONTRACTOR:
LOCATION: 3Z I ��o a�Ytn { �ja�nl��CtP
TYPE OF IAJORK: -,
DATE INSP NEEDED: DATE INSP: 171
INSPECTED BY: &h
WORK IN
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PROGRESS: c 0
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SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: L� DATE:
5/moOoy/Rwm 2014 Town of South Windsor INPS MON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR,CT 06074 FEE $60.00,
Name of Firm_ 4f V i .,SD(,c.e-cf -E 0&.6 q CG Itt 1 Phone No. Y60
Address of Firm / CTtkiZip Code
Location of proposed wor Vt 0 I1.-%0 A0
Describe fully nature.of permit requested �'_ I!�-'1 If0 /�S V CF
Starting date 8 Call Before You Dig No
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE'
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES•IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening 0 Proposed New Driveway
Water Supply: ❑Public Water ❑Well Sewage Service: O Public Sewer ❑Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No. cuts
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Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est.Patch Unit Price$ /sf
Ii w� I�� Ir Est. Patch Cost$
Est.Curb Replacement ft
Est.Curb Unit Price$ /$
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ /sf
Est.Sidewalk Cost$
Est.Traffic Hours hr
v+, Est.Traffic Unit Cost$ /hr
i
Est.Traffic Control$
Amt.of Deposit$
DRIVEWAYS must be'3ft or more from the property line per r Total Due$
section 2.17 of the zoning regulations
Applicant is responsible for contacting the Police Dept.and C.B.Y.D O Cash ( }Check#
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH
WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND
THAT 1 AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH
WINDSOR'S TREET CUT PE IT MANUAL.
Signed Print Name Date: a l4T —��
Engineering/permits/Street Ex nation Permit 2017
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The material contained on this map Title: ( ®�
shall be considered proprietary to
Eversource Energy and user (which is Qp
defined as any person or entity �d �e�� ��
who has received the map through Information shown is not ua-anteed and Eversource Energy > �E R S J'sale, purchase, exchange, gift, or assumes no res onsibil t g CDntractorS arbU R(40�`E
e ur ed to call otherwise) shall keep o in confidence Eversource Energy for further information at lg 800-989-0900 ENERGY
and shall not furnish or disclose it 9y
to any third party without the prior
written permission of Eversouce Energy. Plotted: 17—Jan-2018 By: glsewr1